Medical Staff Credentialing Specialist

SUMMARY

The Medical Staff Credentialing Specialist is responsible for the timely processing of initial credentialing applications and reappointment applications for all providers who are eligible for medical staff privileges.

Essential Duties and Responsibilities include the following. Other duties and tasks may be assigned.

• Maintains the US Renal Care credentialing system to ensure that it is updated in real time, data is current, accurate, and valid.
• Compiles initial provider credentialing applications/ information, and sets up provider files in the US Renal Care credentialing system, and processes the initial credentialing file.
• Monitors applications and follows up with providers as needed, notifies facilities and regional leadership of completed applications.
• Tracks all required provider documents by their renewal dates and receive updated documents by provider prior to their expiration date.
• Processes reappointment applications prior to appointment expiration date, working closely with the provider and provider office.
• Processes reappointment applications for previously archived providers as requested by providers and provider offices.
• Works closely with facility leadership to ensure privileges approval packets are completed and returned to the Medical Staff Credentialing office.
• Provides regular credentialing status updates and reports to Manager, Medical Staff Credentialing
• Provides regular credentialing status updated to provider offices and facility leadership.
• Communicates professionally with all USRC staff, providers, and provider offices.
• Notifies providers, provider offices, and Manager, Medical Staff Credentialing of missing or incomplete information.
• Interacts with medical staff provider offices, applicants, facility leadership, and other stake holders demonstrating the highest level of customer service at all times.
• Performs other duties as assigned by Manager, Medical Staff Credentialing and VP, Medical Staff Credentialing.

• Actively promotes GUEST customer service standards; develops effective relationships at all levels of the organization.
• Participates in team concepts and promote a team effort; performs duties in accordance with company policies and procedures.
• Regular and reliable attendance is required for the job.

Qualifications/Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.

Requirements include:

• Associates Degree or equivalent experience required.
• Two (2) years in Medical Staff credentialing experience.
• Experience with VerityStream (or CredentialStream) preferred.
• Certified Provider Credentialing Specialist (CPCS) preferred.
• Must have proficient computer skills, including Microsoft Office (Word, Excel and Outlook); proficiency in USRC applications required within 90 days of hire.

Benefit Details 

All Full-Time employees are eligible for the following benefits: 
* Medical / Pharmacy 
* Dental 
* Vision 
* Voluntary benefits 
* 401k with employer match 
* Virtual Care 
* Life Insurance 
* Voluntary Benefits 
* PTO 
 

All Part Time employees are eligible for the following benefits: 
* 401k with employer match 
* PTO